Working For ICS

Employment Application Form

The following information will be treated in the strictest confidence.

If you'd prefer to download a copy of the form tocomplete offline, a copy is available here. Please email your completed form to dawn@individualcare.org.uk alternatively, please complete the simplified application form on the job vacancy page or by clicking here.

PLEASE NOTE: Do not navigate away from this page or use your browsers 'Back' button while completing the below form, in doing so form content may be lost.

Fields marked with a '*' are required. Please enter N/A if nothing to add.

Hours applied for: *How much notice are you required to give to your current employer?: *Where did you hear of this vacancy?: *TrainingJob related training coursesAre you training for NVQ Level 2 in care?: *

YES

NO

Name of organisation:Date:Description:Add a second Training Course?:YESNO

Name of organisation:Date:Description:Add a third training course?YESNO

Name of organisation:Date:Description:

Present or last employerAre you currently employed? *

YES

NO

Name of present or last employer *AddressStreet Address:Street Address Line 2:City:Postal Code:Phone Number:Nature of business:Current salary:Job title and a brief description of your duties :Length of service:ReferencesPlease give the names of three people, at least 2 of which should be employment related whom we may approach for a reference.Can we approach your current employer before an offer of employment is made? *

Disclosure and Barring SchemeBecause the nature of the work involves direct contact with vulnerable people an Enhanced Disclosure from the Disclosure and Barring Scheme will be required. Also from July 2010 you will have to apply to be registered with the Independent Safeguarding Authority. The costs of the DBS Disclosure will be borne by Individual Care Services, however should you fail (for whatever reason) to complete 26 weeks employment with the Company the total costs will be deducted from your final pay cheque. We will not use the information obtained through any Disclosures to discriminate unfairly against those with convictions irrelevant or unrelated to the application in hand.Rehabilitation of Offenders Act 1974 (Exception Order)Under the terms of the above order you are not entitled to withhold information about convictions which otherwise might be considered “spent”. In the event of employment, failure to disclose such convictions could result in dismissal or disciplinary action. Please give details of any convictions you might have.DeclarationBy clicking I AGREE, I declare that the information given in this form is complete and accurate. I understand that any false information or deliberate omissions will disqualify me from employment or may render me liable to summary dismissal. *

I AGREE

Date: *Individual Care ServicesEquality and Diversity Recruitment Monitoring FormIn accordance with our Equality and Diversity Policy, we are monitoring job applications to ensure that we provide equal opportunities to any job applicant and make sure that discrimination does not occur because of race, sex, sexual orientation, gender reassignment, religion or belief, marital or civil partnership status, age, disability, or pregnancy and maternity. So that we can assess the success of this policy, we have set up a system of monitoring all job applications. We would be grateful, therefore, if you would complete the questions on this monitoring form and return it with your application form. We have asked for your name in order to enable us to monitor applications at the shortlisting and appointment stage. All information supplied will be treated in confidence and will not be seen by staff directly involved in the appointment. The monitoring form will be detached from your application form, stored separately and used solely to provide statistics for monitoring purposes.

Thank you for your help.ConfidentialGender:

Male

Female

Preferred Title:

Miss

Mrs

Ms

Mr

Dr

Other

Full Name:Marital Status:

Married

Divorced

Single

Widowed

Separated

Other

Ethnic Origin:

White English

Black/Black British

Chinese

White Irish

Asian

Mixed

White Other

Asian British

Other

Disability(The Disability Discrimination Act (1995) – still in force under the Equality Act 2010 - defines disability as “a physical or mental impairment that has a substantial, long-term and adverse effect on a person’s ability to carry out day to day activities.)

Do you consider yourself to be disabled under the Equality Act 2010?

YES

NO

If yes, what is the nature of your disability (optional):Age range:

16-24

25-34

35-44

45-54

55-64

65+

16-24

16-24

The information you have provided here will be stored either as a paper record or on a computer system in accordance with the Data Protection Act 1998 and will be used solely to monitor the diversity of Individual Care Services recruitment regarding Equal Opportunity issues.

Thank you! Your submission has been received!

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Quality Assurance Feedback

"ICS is a professional organisation with a management team who are competent and knowledgeable"Margaret, family member

“Staff work with some very complex people with learning disabilities, enabling them to become independent"A Family member

“It’s the best thing that has ever happened to our son. Staff encourage and promote his independence."James, A fmaily member

“All of the service users appeared to be very happy with the standard of service"Anonymous

"They understand the needs of their client's, and this shows in the quality of the care and support they provide"Learning disability nurse

"We are very happy with the care and support ICS has provided to out daughter over the years, we would definitely recommend them to others."A family member

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